Meta-Analysis
Copyright ©The Author(s) 2021.
World J Gastrointest Surg. Aug 27, 2021; 13(8): 871-884
Published online Aug 27, 2021. doi: 10.4240/wjgs.v13.i8.871
Table 1 Characteristics of studies included
Ref.YearCountryDesignSurgical treatment (No. patients)
Male (%) LL/HLAge, yr1
DiagnosisStage (No. patients) LL/HL




LL
HL

LL
HL





AlSuhaimi et al[15]2019South KoreaRetrospective cohort37883563.8/66.260.2 ± 11.560.6 ± 10.8Rectal cancerNA
Chen et al[4]2020ChinaRetrospective cohort22723551.5/54.058.6 ± 8.957.9 ± 9.1Rectal cancer19/24111/9597/116
Dimitri et al[18]2018GreeceRetrospective cohort447668.2/51.372 (64-77.8)70 (63-79)Rectosigmoid and rectal cancer9/1716/2714/26
Fiori et al[5]2020ItalyRCT242258.3/54.468 ± 1168 ± 9Rectal cancer24/22
Fujii et al[7]2019JapanRCT10810763.0/63.666 (35-88)66 (30-86)Rectal cancer43/4520/2036/364/3
Kverneng Hultberg et al[20]2017EnglandRetrospective cohort43237352.5/63.0NARectal cancer118/86138/128137/12225/24
Lee et al[17]2018South KoreaRetrospective cohort835171.1/66.766.6 ± 10.766.1 ± 11.5Sigmoid colon cancerNA
Matsuda et al[23]2015JapanRCT495169.4/64.767 (45-89) 69 (45-85) Rectal cancer17/717/1513/232/4
Park et al[14]2020South KoreaRetrospective cohort16361365.0/66.462 (31-88) 62 (30-86) Distal sigmoid colon and rectal cancer51/17535/14652/22910/30
Wang et al[22]2015ChinaRCT656364.6/60.358.6 ± 13.756.8 ± 14.2Rectal cancerNA
Yasuda et al[21]2016JapanRetrospective cohort1474262.6/61.968 ± 9.164.5 ± 9.6Sigmoid colon and rectal cancer38/244/2165/19
You et al[13]2020ChinaRetrospective cohort14817466.2/67.258.1 ± 10.857.2 ± 10.5Rectal cancer28/3859/7759/58
You et al[19]2017ChinaRetrospective cohort647256.3/58.360.1 ± 10.858.1 ± 10.9Rectal cancer14/1620/2229/23
Zhou et al[16]2018ChinaRCT525261.5/59.653.9 ± 13.552.7 ± 12.9Rectal cancer4/223/2725/23
Table 2 Quality assessment of included non-randomized trials based on Newcastle-Ottawa scoring system
Ref.
Year
Selection of the research object
Comparability
Measurement
NOS score
AlSuhaimi et al[15]20193137
Chen et al[4]20203227
Dimitriou et al[18]20182136
Kverneng Hultberg et al[20]20173126
Lee et al[17]20182226
Park et al[14]20203137
Yasuda et al[21]20162237
You et al[13]20203238
You et al[19]20172136
Table 3 Endpoints of this meta-analysis
Endpoint
No. of patients
No. of studies
LL
HL
OR WMD (95CI)
I2(%)
P value
Functional outcomes
Urinary dysfunction202971093936OR, 1.23 (0.95-1.59)250.12
Urinary retention10504301749OR, 1.51 (0.85-2.68)00.16
Urinary infection16173633984OR, 0.29 (0.16-0.54)0< 0.0001
Genitourinary dysfunction4582212246OR, 0.32 (0.17-0.61)00.0006
Nocturnal bowel movement8843461423OR, 0.73 (0.55-0,97)00.03
Need for antidiarrheal or laxative drugs18729493OR, 0.70 (0.37-1.30)140.26
Wexner’s incontinence score2743138136MD, -0.01 (-0.71-0.70)760.99
Safety outcomes
Anastomotic leakage45741318302744OR, 0.69 (0.45-1.07)500.10
Anastomotic stenosis6864326360OR, 0.31 (0.16-0.62)460.0009
Postoperative complication262258921730OR, 1.07 (0.66-1.72)620.79
Mortality8226394428OR, 2.70 (0.64-11.40)00.18
Operative time249179961495MD, 4.42 (-2.05-10.89800.18
Blood loss235769131444MD, -0.63 (-4.01-2.76)760.72
Oncological outcomes
Total lymph nodes harvested249179961495MD, 0.68 (-1.03-2.38)940.44
Recurrence13408706634OR, 0.97 (0.73-1.30)00.85
5-year overall survival2821710351786OR, 0.94 (0.61-1.44)610.77
5-year disease-free survival15235602921OR, 0.86 (0.65-1.14)00.29